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Chapter 12: Special Topics: Geriatrics

CLINICAL APPLICATION OF FOUNDATIONAL SCIENCES

In 2011, the Federation of State Boards of Physical Therapy (FSBPT) issued a conservative estimate that older adults (ages 65-85) accounted for 40% of all physical therapy services and contributed to both the large growth in the profession1,2 and the projected future shortages of physical therapists (Figure 12–1).* In addition, the old-old were, and continue to be, the fastest growing component age group in the United States.3

FIGURE 12–1

Physical therapist supply and demand. 2016 Projections using attrition rate of 3.5%. FTE, full-time employees. (Reproduced with permission from American Physical Therapy Association. Copyright ©2017 American Physical Therapy Association. All rights reserved https://www.apta.org/WorkforceData.)

A graph depicts the increase in supply of F T E's and demand.
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Caring for this aging tsunami3 requires the entry-level physical therapist (PT) to: (1) differentiate normal expected changes from unexpected changes, (2) care-plan and create interventions across the patient-client life spectrum while collaborating with families and interprofessional teams, (3) provide caregiver, family, and patient-client support and training, and (4) advocate for both health promotion and safety.4 Chronic conditions such as heart disease, stroke, diabetes, and arthritis are projected to continue to grow (Figure 12–2) in aging adults, requiring the competent skilled services of the PT to reduce morbidity and mortality.

FIGURE 12–2

Chronic health conditions. (Reproduced with permission from Centers for Disease Control and Prevention. National Center for Health Statistics.)

A bar graph shows the percentage of chronic health conditions occurring in men and women.
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High-Yield Terms to Learn
Ageism Age discrimination; occurs when bias is the primary motivation behind acts against a person or group.
Agnosia Failure to recognize or identify objects despite intact sensory function.
Apraxia Impaired ability of previously learned motor activities yet intact motor function.
Component age groups

Chronological age is defined as age in years, and is therefore easily determined. For convenience and simplicity, the following terms are used for the component age groups:

  • Middle-age: 45 to 64 years

  • Young-old: 65 to 74 years

  • Old: 75 to 84 years

  • Old-old: 85 to 99 years

  • Oldest-old: 100+ years
Concreteness Recognizing concrete concepts but not abstract concepts or words.
Dementia-related memory loss Initially short-term with progression to include long-term memory.
Durable power of attorney for health care “Durable power” allows a patient to name a “patient advocate” to act on behalf of the patient and carry out his or her wishes.
Geriatrics The branch of medicine that focuses on health promotion and the prevention and treatment of disease and disability in later life.
Gerontology The study of the aging process and the science related to the care of the elderly.
Life expectancy Life expectancy, the number of years an individual can expect to live, is based on average life spans. Men generally have lower life expectancy rates than women at every age.
Life span...

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